Meditations on the sacred page and other books

The practice of routine infant circumcision, currently carried out in several English-speaking countries, originated for several reasons, but one by far outstrips the rest: prevention of masturbation. I realize that initially this seems implausible to the twenty-first century reader for two reasons. First, it is well-known that circumcised men masturbate. Second, masturbation does not seem to be a medical issue. However, both of these objections reveal the historical distance between today and the world of nineteenth century Britain, from whence all (medical) routine infant circumcision derives.

Circumcision was not practiced in Europe except by Jews and Muslims. Christians had long since decided that circumcision was a ceremonial custom of the Old Testament that Christ had abolished. Medical textbooks treated the penis as a unity, distinguishing different parts but in no way asserting that certain pieces might be unnecessary or somehow less than the “real” penis. In fact, European society until the nineteenth century can be described as anti-circumcising. There was periodic fear that Jews were secretly plotting to kidnap and circumcise Christian babies, or that Muslim hordes would capture groups of men and circumcise them as war trophies.

The changes began in the eighteenth century with a well-documented phenomenon called “masturbation phobia.” Contrary to the contemporary secular mindset, it was believed that moral ills and bodily ills were linked, not so much by direct divine retribution but rather by the laws of nature. Masturbation had long been considered a particularly heinous crime – medieval confessional manuals ranked it more serious than incest – but in the eighteenth century the clergy would close ranks with the medical community for the common welfare of the people. It is worth remembering that only in the 18th century did the medical community begin its ascent to the status of social authority, due primarily to its supposed acceptance of the scientific method.

Two medical paradigms, one outgoing and the other incoming, were both employed against masturbation. The older one, soon (but not soon enough) to be discarded was the Galenic theory of the humours. The human body was assumed to be composed of four fluids which, when out of balance, caused sickness. Balance was restored by adding or subtracting fluids. Sperm came to be viewed as a particularly concentrated fluid, worth by some estimates up to forty times the volume of blood. Under this model, even normal sex could be dangerous; masturbation was simply insane. Medical manuals such as Onania and Onanism catalogued the potential damage from masturbation: weakened intellect, loss of bodily strength, pimples, intestinal diseases, etc. In the nineteenth century, Claude-Francois Lallemand would invent the diagnosis “spermatorrhea,” any non-urine secretion from the penis. Notice how all normal sexual functions became pathologized.

The incoming medical paradigm was nerve force theory. New discoveries of electricity and the nervous system led physicians to view the body as a complex electrical system which required unhindered energy flow. (In my opinion, this resembles Eastern ideas of chakra.) Nerve force theory precipitated the rise of circumcision in several ways. First, many physicians, such as medical giant Lord Action, viewed the human body as a finite energy resource. Humans only get so much energy, so they must expend it wisely. Second, some physicians concluded that orgasm was a nervous shock that could potentially damage the brain. This led Acton, along with others, to urge great sexual restraint. The prevailing idea was that sex should be as infrequent as possible, since it depleted your total energy reserves and the shock might hurt or even kill you. Understandably, masturbation came to be seen as the most unhealthy thing a person could do, and all sectors of British society mobilized to prevent it.

Medical publications such as the Lancet were debating methods to prevent masturbation. Schools were flogging and/or expelling boys for masturbating. Parents were extremely active as well. “A number of physical interventions were tried before the medical profession settled on circumcision as the most efficient, including chastity devices, infibulations, blistering, castration, and cutting the main penile nerve…. Various chastity devices were tried, ranging from such mild measures as mittens or tying the hands to the bedrail overnight to more extreme contraptions such as straitjackets and cages over the genitals” (Darby, 196-7).

At this point it should be clear that British society was motivated to act against masturbation. But why choose circumcision? Although this knowledge seems scarce in contemporary America, most men throughout history have known that the foreskin is extremely involved in the sexual act. The foreskin is itself an erogenous zone and carries out several functions related to the pleasure of both partners. Removal of the foreskin significantly reduces male sexual sensitivity and does, in fact, make masturbation more difficult. There is some reason to believe that circumcision does reduce the amount of “playing with genitals” in pre-pubertal boys. At puberty, however, hormones arise and circumcision makes very little difference in the prevalence of masturbation.

At first, British doctors practiced circumcision on boys and adolescents caught masturbating, usually after blistering treatments or cauterization by catheter failed to be effective. Circumcision was usually without anesthetic, so that boys would remember the pain and let that be a lesson. Girls caught masturbating would sometimes have an acidic substance rubbed on their genitals, causing painful blistering for a few days. Clearly, medical ethics was in its infancy. Still, it is quite a leap from these practices to routinizing circumcision for infants. There were several factors that bridged this gap.

Since eighteenth and nineteenth century medicine had made little progress in actually curing diseases, preventive medicine was the prevailing strategy. The introduction of germ theory, at first poorly understood in Britain, reinforced the urban sanitation strategies. Cleaning up the cities had indeed improved the health of the populace. Doctors wondered if the human body had similar dirt traps that bred infectious disease. The natural lubrication of the penis, smegma, was declared an infection-bearing ooze. To give some perspective, around the same time routine circumcision was becoming popular, doctors were cutting out teeth, tonsils, appendices and even colons, presuming them to be similar dirt traps. All of these “preventive” surgeries became popular after Listerism (keeping surgical areas and devices clean) reduced the risk of surgery.

Finally, the cause of routine circumcision was advanced by a misdiagnosis, “congenital phimosis.” In adults, the inability to retract the foreskin is usually caused by an infection, and can be an uncomfortable and painful condition. Delivery room doctors began noticing that many of the infants had adherent foreskins. They supposed that this was abnormal, a congenital defect. A new diagnosis was formed, “congenital phimosis,” and the recommended treatment was circumcision. CP was regarded as a serious condition not primarily on account of discomfort, but because it was supposed that a tight, constricting foreskin would irritate the penis in such a way as to cause abnormal sexual arousal. Another culprit in the masturbation menace had been identified. Strangely, CP seemed to be an epidemic, as the vast majority of male infants met the description. In the 1940s, Douglas Gairdner conducted extensive research into the development of the foreskin and concluded that the foreskin naturally adheres to an infant, gradually becoming looser and retractable usually before puberty. The congenital phimosis diagnosis testifies to the loss of medical knowledge about the foreskin in the nineteenth century.

Yes, there were secondary causes for the institution of routine infant circumcision (such as the “miracle cures” of Lewis Sayre), but by far the primary cause was the masturbation phobia. Pseudo-medicine and social morals conspired to deprive males of a correctly functioning, utterly natural body part. After the debunking of the various medical theories regarding circumcision, Britain experienced a sharp decline in circumcision rates to nearly zero at the present. Routine infant circumcision is practiced (for supposedly medical reasons) only in the English-speaking world and is in each case traceable back to British medical opinion. Canada, New Zealand, and Australia all went through a period of routine infant circumcision, but now in those countries circumcision is a minority practice. Only the United States persists in this dubious practice, although it has long since forgotten its reasons for doing so.

[Post-script: I’ve read a number of works on the history of circumcision. I will recommend two very helpful ones. First is Circumcision: A History of the World’s Most Controversial Surgery by David Gollaher. Gollaher is an award-winning history author and is a leader in several organizations at the forefront of medical and scientific research. His book is a very satisfying general introduction to all kinds of circumcision, weighted somewhat toward the contemporary Western situation. The second is Robert Darby’s A Surgical Temptation: The Demonization of the Foreskin and the Rise of Circumcision in Britain. Darby’s work is very thorough, building on a number of important studies on British sexuality, society, and medical practice throughout the eighteenth and nineteenth centuries.]

… There is a movement of Jews who are questioning circumcision, and working to end this abuse of children. The movement ranges from the Orthodox to the secular, and includes mothers, fathers, scholars, historians, medical professionals, activists, and intellectuals.